Politics & Government

New state health leader Mandy Cohen makes opioid treatment a priority

Dr. Mandy Cohen, the new state Department of Health and Human Services secretary, has made tackling opioid addiction in the state a top priority for the department.

Earlier this month, she sent a letter to doctors in the state, asking them to take steps to prevent patient abuse of prescription drugs. Gov. Roy Cooper’s budget also directs $12 million in community mental health funding toward addiction treatment.

Cohen said at a meeting Thursday with The News & Observer’s editorial board that she wants to set priorities for the department that align with interests in the Republican-led legislature. Republican legislators filed a bill, which Democratic Attorney General Josh Stein supports, that would take a multi-pronged approach to stemming opioid abuse and spend $20 million over two years on community-based drug treatment.

“I see alignment there,” Cohen said. “I see common ground. Let’s talk there and think how we can help that population that wants treatment.”

Cohen, 38, is a former high-level administrator at the federal Centers for Medicare & Medicaid Services. She takes over one of the state’s largest departments in the early stages of its move toward major changes in how doctors and hospitals are paid for treating about 1.9 million people who use Medicaid, the government health insurance program for the poor, elderly and disabled.

The state wants to stop paying for each doctor’s visit and procedure and give managed-care organizations a set amount of money for each patient. The state must get federal approval for changes. Getting to a launch date will take years.

Cohen said she’s excited about the new approach because it will open up new ways to help people stay well by considering how housing, nutrition and other factors affect their health.

“The payment changes that are coming are an opportunity to integrate some of these kinds of things,” she said.

The legislature built in a several-year lag before the state’s regional mental health system is integrated with physical health. Cohen sees the lag as a problem. General health care has advanced with the use of electronic records to track quality, and the mental health system hasn’t kept pace, Cohen said.

“There’s universal consensus on everyone being frustrated with the current system,” she said. “There’s not consensus on what to do next.”

Cohen is due to have a Senate confirmation hearing later this month. She received a subpoena Wednesday.

She said she’s been meeting with legislators about her approach to the job. She thinks senators will ask hard questions at the hearing, but she doesn’t believe she’ll have trouble getting approved.

“I think we’ve already gotten off to a good start on a working relationship,” she said.

Lynn Bonner: 919-829-4821, @Lynn_Bonner